Case report

Difficulties in establishing a timely diagnosis of pulmonary artery sarcoma misdiagnosed as chronic thrombo-embolic pulmonary disease: a case report

Ivanka Djordjevic¹ , Tatjana Pejcic¹ , Milan Rancic¹ , Milan Radovic¹ , Petar Bosnjakovic² , Tatjana Radjenovic-Petkovic¹ , Desa Nastasijevic-Borovac¹ , Slavica Golubovic¹ and Dragana Dacic¹

¹  The Clinical Center Nis, Clinic for lung diseases, Department for non specific lung diseases, Bul. Dr. Zorana Djindjica 48, 18 000 Nis, Republic of Serbia

²  The Clinical Center Nis, Institute for Radiology, Bul. Dr. Zorana Djindjica 48, 18 000 Nis, Republic of Serbia

author email corresponding author email

Journal of Medical Case Reports 2009, 3:64doi:10.1186/1752-1947-3-64

Published:	16 February 2009

Abstract

Introduction

Pulmonary artery sarcomas are rare neoplasms that are often confused with chronic thrombo-embolic disease, as both can have similar clinical and imaging presentation.

Case presentation

In this report, we present a case of a 50-year-old man initially diagnosed with chronic thrombo-embolic pulmonary disease, but who was later found to have pulmonary artery sarcoma with poor survival prognosis. We review the clinical and imaging characteristics of the two diseases and discuss the difficulties in establishing a timely diagnosis.

Conclusion

Similar clinical features and imaging presentation of pulmonary artery sarcoma and chronic thrombo-embolic pulmonary disease make definitive diagnosis difficult. This case report also illustrates and emphasizes that in any case with no predisposition factors for embolism, no evidence of deep venous thrombosis and pulmonary emboli, and inadequate relief of symptoms with anticoagulation, an alternative diagnosis of pulmonary artery sarcoma should be considered. If pulmonary artery sarcoma is diagnosed late in the course of the disease, there is usually a poor survival outcome.